A randomised clinical evaluation of a fluoride mouthrinse and dentifrice in an in situ caries model

J Dent. 2018 Mar:70:59-66. doi: 10.1016/j.jdent.2017.12.015. Epub 2017 Dec 28.

Abstract

Objectives: Fluoride mouthrinses provide advantages for fluoride delivery by maintaining elevated intra-oral fluoride concentrations following fluoride dentifrice use. This in situ caries study investigated potential anti-caries efficacy of a 220 ppm fluoride mouthrinse.

Methods: This was an analyst-blinded, four-treatment, randomised, crossover study using partially demineralised, gauze-wrapped, human enamel samples mounted in a mandibular partial denture. Participants brushed twice daily for 14 days with either a 1150 ppm fluoride or a fluoride-free placebo dentifrice and either rinsed once daily with the 220 ppm fluoride mouthrinse or not. Following each treatment period, percent surface microhardness recovery (%SMHR) and enamel fluoride uptake (EFU) were assessed.

Results: Fifty three participants completed the study. Compared with the placebo dentifrice/no rinse treatment, the fluoride-containing regimens demonstrated greater enamel remineralisation (%SMHR) and fluoridation (EFU): fluoride dentifrice/fluoride rinse (%SMHR difference: 21.55 [95% CI: 15.78,27.32]; EFU difference 8.35 [7.21,9.29]); fluoride dentifrice/no rinse: 19.48 [13.81,25.15]; 6.47 [5.35,7.60]; placebo dentifrice/fluoride rinse: 16.76 [11.06,22.45]; 5.87 [4.72,7.00] (all P < .0001). There were no significant differences in%SMHR between fluoride regimens. The fluoride dentifrice/fluoride rinse regimen was associated with higher EFU than the fluoride dentifrice/no rinse (1.88 [0.75,3.01], P = .0013) and placebo dentifrice/fluoride rinse regimens (2.48 [1.34,3.62], P < .0001). Treatments were generally well-tolerated.

Conclusions: The in situ caries model demonstrated that the fluoride mouthrinse is effective in promoting enamel caries lesion remineralisation and fluoridation whether used following a fluoride or non-fluoride dentifrice. Additive (potential) anti-caries benefits of a fluoride rinse after a fluoride dentifrice were confined to enhancements in lesion fluoridation (EFU).

Clinical significance: In conjunction with a fluoride dentifrice, fluoride mouthrinses enhance enamel fluoridation, which may be useful in caries prevention.

Keywords: Caries; Dentifrice; Fluoride; In situ model; Mouthrinse; Remineralisation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cariostatic Agents / therapeutic use
  • Cross-Over Studies
  • Dental Caries / pathology
  • Dental Caries / prevention & control*
  • Dental Enamel / drug effects
  • Dental Enamel / pathology
  • Dentifrices / administration & dosage
  • Dentifrices / therapeutic use*
  • Drug Combinations
  • Female
  • Fluorides / administration & dosage
  • Fluorides / therapeutic use*
  • Hardness
  • Humans
  • Male
  • Middle Aged
  • Mouthwashes / administration & dosage
  • Mouthwashes / therapeutic use*
  • Saliva / chemistry
  • Sodium Fluoride / therapeutic use
  • Surface Properties
  • Tooth Remineralization
  • Toothbrushing
  • Treatment Outcome
  • Young Adult

Substances

  • Cariostatic Agents
  • Dentifrices
  • Drug Combinations
  • Mouthwashes
  • Sodium Fluoride
  • Fluorides